I realize that it's a cliché to say so, but some clichés are true. Time really does fly. It's hard to believe that a year ago California—and, by proxy, the rest of the country—was in the throes of a major political war over the bill SB 277. SB 277, you will recall, was a bill introduced into the California Assembly in the wake of the Disneyland Measles outbreak in early 2015 that eliminated non-medical exemptions to school vaccine mandates beginning with the 2016-2017 school year. Ultimately, SB 277 passed and was signed into law by Governor Jerry Brown last July. It was an uncommon victory for science and public health, and already appears to be having a positive effect on vaccine uptake in kindergarten children.
Unfortunately but not unexpectedly, to say that the proposal and passage of SB 277 into law drove the antivaccine movement into even greater fits of crazy in response is to put it mildly. It became a common trope on antivaccine websites and blogs to see SB 277 compared to fascism, in particular the Holocaust. Robert F. Kennedy, Jr. and "Dr. Bob" Sears explicitly compared SB 277 to the Holocaust. Truly, the Godwin was strong in the antivaccine movement. One particularly offensive meme that went around at the time consisted of antivaccinationists suggesting that SB 277 was a major step in the direction of requiring unvaccinated children to wear a badge or armband to identify themselves, the way that the Nazis required Jews to wear badges or armbands with a yellow Star of David on them. One, Heather Barajas, even went so far as to be photographed with her children wearing such an "unvaccinated" badge and juxtapose that photo with photos of Jews from the Third Reich wearing yellow Stars of David.
The flaw in SB 277
SB 277 is generally a good law, but it's definitely not perfect. Perhaps its most glaring weakness is that all that it requires for a child to obtain a medical exemption is a letter from the child's doctor. In other words, any physician can provide a letter for parents to use to get a vaccine mandate. It's useful to look at the other two states that do not allow nonmedical exemptions to school vaccine mandates, Mississippi and West Virginia. Basically, in its acceptance of the word of basically any physician, SB 277 is similar to Mississippi law. In contrast, in West Virginia, it isn't just the word of the child's physician that matters; all requests for medical exemptions are reviewed by an Immunization Officer, who determines if they are appropriate "based upon the most recent guidance from the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) with respect to medical contraindications or precautions for each vaccine."
On the surface, SB 277 would indeed seem to be a godsend to antivaccine pediatricians, who will likely see their business boom in the wake of SB 277, as parents, no longer able to get nonmedical exemptions, start looking for medical exemptions, much the way parents in states that allow religious exemptions but not personal belief exemptions, suddenly found religion and used it as a justification for not vaccinating. Resistance will flow wherever it can. I'm just happy that, in this case at least, only letters from a physician will be valid for obtaining a medical exemption; one could only imagine what would happen if letters from naturopaths and chiropractors, who, unfortunately, are licensed "health care professionals" in the state of California, were permitted. Over at my not-so-secret other blog, I predicted this would happen based on statements of antivaccine-friendly pediatricians such as Dr. Jay Gordon and Dr. Bob Sears last summer.
Now, as the 2015-2016 school year winds to a close and parents are thinking about the 2016-2017 school year, I have discovered that my predictions were correct.
A gold rush among antivaccine-sympathetic pediatricians
Over the weekend, I saw this story by Kaleigh Rogers, "California Doctors Are Advertising Ludicrous Medical Exemptions to Anti-Vaxxers", that appeared to confirm my predictions:
Dr. Tara Zandvliet, a pediatrician based in San Diego, has a pretty typical doctor's website. The design is reminiscent of a late-90s Dreamweaver template; the color palette is beige, yellow, and brown. There's an online system where you can book an appointment, a list of the services she offers and the prices, and a short bio listing her credentials.
But there's one part of the site that stands out: a page that lists qualifying conditions to obtain a medical exemption from having your child vaccinated. These conditions include things like asthma, eczema, and psoriasis, and for $120 per child, Zandvliet will offer a 40-minute consultation to decide whether or not you qualify.
Last year, California changed its laws to eliminate personal belief and religious exemptions for vaccines. These exemptions were what anti-vaxxer parents had been using to continue sending their kids to school unvaccinated. Now, in order for children to attend school (private or public) in California, they must be up to date on the required shots. No special treatment for personal beliefs. So some parents are now turning to medical exemptions to take the place of their personal belief coverage.
Unsurprised but curious, I wandered over to Dr. Zandvliet's website, screen captured her page and saved it as a web archive (in case it disappears down the old memory hole). The list of qualifying conditions for medical exemptions is long and—shall we say?—not what I would call evidence-based. Sure, there are accepted indications there, such as immunodeficiency, malignancies whose treatment causes immune suppression, and a history of severe reactions to vaccines and vaccine components. Then, however, there's a cornucopia of non-evidence-based reasons, including:
Hyper immune conditions
Including, but not limited to:
Allergies to food, bee stings, medicines that include hives/swelling/wheezing (hay fever does not count)
Including, but not limited to:
Mixed connective tissue
Hashimoto or Graves thyroid (not regular low thyroid)
Rheumatoid arthritis (not old age or overuse arthritis)
Type 1 diabetes (child type)
Let's just put it this way. None of the above conditions is a contraindication to vaccination. Indeed, the list of true contraindications to vaccination is brief, and very little of what's on Dr. Zandvliet's list is on that list. I suppose I should give Dr. Zandvliet credit for one thing. At the end of the list, it does say that autism, autism spectrum disorder, and behavioral issues are "not sufficient to meet medical exemption requirements." Goody for her. I was kind of depressed to note that Dr. Zandvliet is double-boarded in internal medicine and pediatrics, which is very difficult to accomplish. She's also board certified in integrative medicine; of course, as I pointed out before when that board certification was first announced, it's a highly dubious board certification, to say the least.
In other words, Dr. Zandvliet's practice consists of "integrating" quackery with science- and evidence-based medicine, because that's what integrative medicine is, by definition. If you don't believe me, just check out Dr. Zandvliet's FAQ, where she does the antivaccine shuffle in which she concedes that vaccines "can save lives" but she believes in "talking to parents about the necessity of some of the less essential vaccines" and often suggests "alternative" vaccine schedules. Elsewhere, she points out how she prefers "lifestyle changes to medication," believes that "acupuncture and Chinese herbal medicine are based in science that has yet to be understood fully," and supports the "use of nutritional supplements."
Not surprisingly, Dr Zandvliet testified last year against SB 277, invoking the same sorts of overblown claims of vaccine "injury" and "health freedom" that we're used to seeing from SB 277 opponents:
She could be "Dr. Bob" or "Dr. Jay." Speaking of Dr. Bob (Dr. Bob Sears, that is), not surprisingly, he makes an appearance in the article.
Dr. Bob: A trailblazer in selling nonmedical exemptions
Shortly after the passage of SB 277, I and others were already speculating that some antivaccine doctors would see the law as an excellent chance to profit. Let’s do a brief recap, given that it’s been nearly a year.
For example, on Twitter:
@gorskon @MyHealthyBabies @JayGordonMDFAAP No doubt some CA doctors will profit from this. I hear Bob just ordered a new Lamborghini.
— Greg Hinson (@ackdoc) June 30, 2015
Meanwhile, our old friend Dr. Jay Gordon wrote:
Governor Brown signed this law because of the strong medical exemption provisions. He recognized that parents with reasonable medical objections—as opposed to personal or religious objections—must still have access to exemptions for their children.
Consult with a physician who knows your child and your family.
No one should scare you into or out of vaccinating.
Dr. Jay often plays the "false balance" card, making it seem as though pro-science vaccine advocates are desperately trying to "scare" parents into vaccinating, when it's really antivaccine activists who are trying to scare parents out of vaccinating with false claims that vaccines cause autism, diabetes, sudden infant death syndrome, asthma, and a plethora of other diseases and conditions. Be that as it may, Dr. Jay isn't really the culprit here. He's just pointing out a loophole in the law that's big enough for Dr. Bob to drive a Lamborghini through, something we discover later in Rogers' article, when she cites a Facebook post from last July by everybody's favorite antivaccine-sympathetic (if not outright antivaccine) pediatrician, Dr. Bob Sears:
The key passage reads:
The guidelines for providing medical exemptions are extremely broad in the new California law. Parents, physicians, legal experts, and some legislators fought to have the term "contraindication" removed from the guidelines, and succeeded. This means that is it up to the personal judgement of each physician and patient to work together to determine if a child qualifies for a medical exemption. The California bill declares that an exemption can be granted if "the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances including, but not limited to, family history, for which the physician does not recommend immunization . . ."
While it's true that Dr. Sears recommended against seeking medical exemptions "now," remember that this Facebook post was written 10 months ago, over a year before the 2016-2017 school year is to begin. His reasons for recommending against seeking medical exemptions then was purely strategic, because there is a provision in SB 277 that grandfathers in children who already had exemptions. They can continue to use those exemptions until they hit a new grade span (starting preschool, entering kindergarten, or beginning the seventh grade), at which point they'll need to be up to date on their vaccines.
I don’t feel the need to review any more of Dr. Bob’s scheming last summer. I discussed Dr. Bob’s discussions of, in essence, selling medical exemptions, all with plausible deniability when he was holding seminars and posting to Facebook. It turns out that nothing’s changed. Dr. Bob is still at it, as you will see.
The antivaccine quackery continues
If you want to see just how much Dr. Bob has aligned himself with the antivaccine, pro-quackery movement, consider this: He's still giving seminars on how to obtain medical exemptions; only now he's charging $20-$50 a pop for them. For example, this very week on May 11, if you live near Irvine, CA, you can attend a seminar in which Dr. Bob will appear with a homeopath, "Dr. Bob Sears - Mandatory vaccine laws: Are they necessary? Will they even work? What are your options? Homeopath Tania - Homeoprophylaxis for immune boosting." That's right. Dr. Bob is appearing side-by-side on stage with a practitioner of The One Quackery To Rule Them All, homeopathy. This practitioner, Tania Dilmani, offers just as much quackery on her website as you would expect from a homeopath, plus an amazing helping of self-promotion as well.
Unfortunately, Dr. Bob is not alone on the medical exemption seminar circuit in California—webinar circuit, actually. Rogers cites another med-peds doc, Dr. Kelly Sutton, who is offering webinars on how to avoid the requirements of SB 277 by seeking medical exemptions to school vaccine mandates. Shockingly (that's sarcasm, obviously), Dr. Sutton practices anthroposophic medicine, one of the quackiest of quack medicines. Her website describes her approach thusly:
Dr. Sutton bases her diagnosis in part on conventional medicine: history, physical, laboratory and imaging, and subspecialist consultation when needed. Significant understanding arises from listening to aspects of an individual's biography, life purpose, the emotional context of illness and health, and understanding the level of vitality and strength of the life forces. She treats acute and chronic illness using the least toxic effective treatment for the condition. Anthroposophic remedies (low potency homeopathic preparations and herbs), diet, nutritional supplements, healthy rhythm, warmth are some of the foundational principles she employs. Anthroposophic therapies play a key role in treatment.
Yep. More homeopathy.
She bills her seminars as the "Step-by-step Program to Help Protect Your Child from the 'One Size Fits All' California Vaccine Mandate!," promising to provide the "tools and knowledge you need to protect your rights as a parent to choose the healthcare of your child" and take attendees "from cornered to confident." She offers this all for $27—but only if you take advantage of the early bird special. You can get a taste of what she's offering here. I must admit that I laughed out loud when Sutton started her webinar out by claiming that her presentation is neither antivaccine nor pro-vaccine, but rather pro-parent. This, of course, led me to ask" What about pro-child?" That's because antivaccine views seem to be always far more about the parent than the good of the child. Indeed, as I've pointed out many times before, the attitude of many antivaccine parents is that their rights matter more than that of the child and that the child is essentially their property.
Even more hilariously, Sutton tells parents to trust themselves and that no one cares more or knows more. Really? I'd say scientists and pediatricians know more than the vast majority of parents about vaccines, their indications, their benefits, and their risks. Sutton is basically massaging her marks to assure them that they're the smartest ever and no one knows more about the topic at hand than they do. The rest of the video is chock full of antivaccine misinformation and tropes, such as the "vaccines didn't save us" gambit, and the claim that Pasteur was wrong. I was also shocked at how amateurish the graphics in the webinar were, as well.
Finally, I've discussed how genetic profiling is still in its infancy, even for cancer. Even so, quacks do so love to get ahead of the science and claim to be able to use it to diagnose and treat conditions. Rogers called a number of clinics listed on Bob Sears' website posing as a patient asking about a medical exemption for her children and noted:
I also cold-called a random selection of California clinics listed on Sears's website as "vaccine friendly," and posed as a patient inquiring about medical exemptions. Most of the clinics told me it was highly unlikely my child would qualify for a medical exemption and that they would not consider it for anyone who wasn't already an established patient.
But a few offered other responses. One clinic told me new patients hoping for a medical exemption must first get DNA testing done by 23andme, "so that we have proof of a genetic predisposition." Another suggested I use the form on Zandvliet's site as a guideline before coming in for a consultation. One other suggested I attend an upcoming seminar hosted by Sears.
There is, of course, no convincing (or even suggestive) evidence that 23andme testing can reliably identify genetic predispositions to adverse vaccine reactions. Any clinic making this claim is just making it up as it goes along. I expect, however, to see a lot more of this.
What can be done?
Clearly, the great leeway granted physicians in identifying diseases and conditions upon which to base a letter supporting a medical exemption to school vaccine mandates for an individual patient is a feature, not a bug, in SB 277. It was a compromise without which the bill likely would never have become law. So the question will be: Can anything be done to prevent antivaccine-sympathetic doctors from issuing vaccine mandates to just about anyone. Ten months ago, I sarcastically predicted:
.@MyHealthyBabies I suspect @JayGordonMDFAAP's "medical criteria" for exemption under #SB277 will be "Mommy and Daddy want it."
— David Gorski (@gorskon) June 30, 2015
Clearly, doctors like Bob Sears, Tara Zandvliet, and Kelly Sutton are doing their best to make my prediction come true. What kind of push-back can they expect?
Unfortunately, there's not much that can be done. Rogers points out that the percentage of children with medical exemptions in California is below 1% and has been stable for decades. If that rate starts to rise, it could be an indicator that more doctors are offering more dubious medical exemptions. However, it could take years for such an increase to manifest itself, because many California children are still grandfathered in with their nonmedical exemptions and won't be facing a school year where they have to catch up on their shots for years. Rogers notes:
It's also not totally clear that, if a doctor did offer a medical exemption for a child because his or her grandmother has psoriasis, it would be illegal. There are no official "rules" for what qualifies a patient for a medical exemption, outside of the CDC's recommendations, and the law leaves it up to the discretion of the doctor. In general, that's a good thing, because it would be difficult to very precisely account for every possible situation when a medical exemption would make sense.
I disagree. The vast majority of these "possible situations" are not indications for medical exemptions, as the number of such indications is few and the indications are clear. West Virginia, as I pointed out above, doesn't leave it just to the physician's discretion. It double checks the reason given for a requested exemption before permitting that exemption.
Really, the only option, barring a change in the law, is the state medical board, as Rogers quotes law professor and pro-vaccine advocate Dorit Reiss discussing:
But it also opens up the possibility of medical exemptions being used to fill the role of personal belief exemptions. The only way a doctor might be subject to discipline for handing out questionable medical exemptions would be through the Medical Board of California.
"You could complain to the board and say it's a violation of the standard of care, but it's not formalized," Reiss said. "Doctors that advertise online saying they'll give medical exemptions are kind of natural targets. They kind of deserve to be closely monitored."
A spokesperson for the Medical Board told me it's not specifically monitoring who gives out medical exemptions or how many, but that just like anything else a doctor does, this decision would need to meet the board's standard of care.
Given how toothless most state medical boards are, I wouldn't hold my breath waiting for California's board to go after the Dr. Bobs of its state. Contrary to Rogers' assertion, this aspect of SB 277 is toothless and California will have to depend on the essential honesty and science-based practice of the vast majority of its pediatricians and family practice doctors. That appears to have been enough in Mississippi, but whether it will be enough in the woo-friendly, antivacine-riddled state of California remains to be seen. I'm cautiously hopeful that it will be, but I wouldn't be surprised to be wrong.
Don't get me wrong. The passage of SB 277 is a major victory in the struggle to protect children from the ravages of infectious disease and a major defeat for the antivaccine movement, which marshaled pretty much everything it had to defeat it and still came up short. But it is not perfect. It's politics. Compromises had to be made. SB 277 makes the situation in California much better than it was before with respect to child health and should serve as a model for the remaining 47 states that allow religious and personal belief exemptions. It is a beginning, not an end, and part of what needs to be done now is to keep an eye on its implementation.
- Log in to post comments
Given that a large number of these conditions are emphatically not contra-indications for immunisation (e.g. coeliac), surely her State medical board must take an interest? This clearly departs from standard of care, and it's very similar to the bullshit that got Jayne Donegan into hot water in the UK.
State boards should be reminded, they have the privilege of certifying physicians, not a right. Privileges can be administratively revoked and alternative certifiers and licensers can be created by the appropriate legislation.
To steal a page from anti-abortion types, specific scripts can also be required to be read by the physician, with a loss of license to occur if there are deviations from the prepared, evidence based script.
In short, I'm getting really, really tired of woo peddling and prostituting of medical licenses and if the current structure is unwilling or incapable of policing their ranks, that structure can be easily replaced.
I would encourage readers to contact the state medical board. Asthma is not a contra-indication for immunisation, in fact any reality-based immunisation programme prioritises asthma patients for flu shots in particular, for obvious reasons.
Coeliac is also not a contra-indication for immunisation. Neither is Crohn's. The list of purported contra-indications is a grab bag of bullshit.
I'm not about to give Dr. Bob or Dr. Sutton any of my money, but do their seminars offer any substantive advice beyond scheduling a consultation with them (for something like the $180/hr that Dr. Zandvliet charges for this service)? At least Zandvliet isn't trying to hide what she's doing. I don't trust Dr. Bob to be honest about anything, and for me "webinar" is a red flag, so I wouldn't trust Sutton either.
I understand SB 277 is leading to an increase in vaccinaton uptake, just like the Australian no jab no pay law did, although I havn't seen the data. People who think they are anti-vaccine are deciding that they are not really anti-vaccine when it is going to cost more or be more complicated.
The Zandvliet's of this world who advertise their special services on-line leave themselves open to action by medical boards, because it always looks bad for the profession if doctors are seen to be flauting the rules. Should there be sufficient pressure, no doubt there will be some action, but first there needs to be a formal complaint about the activity.
"One clinic told me new patients hoping for a medical exemption must first get DNA testing done by 23andme, “so that we have proof of a genetic predisposition.”
Even if this doesn't involve a kickback or other financial incentive for a medical practice, there should be zero compulsion for patients to spend money on testing to obtain a medical exemption, even if such testing was valid in this instance. Since there is no accepted test I'm aware of to diagnose susceptibility to vaccine reactions, it sounds like something a medical board should consider as a possible violation of standard of care.
I’ve had this for 25 years or so and also had many vaccines in the same time span. Guess I should definitely be autistic (or dead) by now.
and for $120 per child, Zandvliet will offer a 40-minute consultation to decide whether or not you qualify.
How many parents pay the $120 per child fee, only to be told "sorry, little McKaydynnleigh doesn't qualify, all the shots for her!!1!"
Also, let's take eczema (why not) -- there are a whole lot of kids with eczema. https://nationaleczema.org/research/eczema-prevalence/
Dr. Zandvliet gives some really bad vaccine advice:
My guess is there won't be a flood of bogus medical exemptions, just a handful. I don't think the rise in vax uptake in CA is due solely to the difficulty of getting a medical exemption. I do think the raised bar helps, but to me the great value of SB277 is that it's functions more as persuasion than force. You never get very far trying to force obstinate people to obey some set of rules. The Disneyland outbreak changed things here in CA in ways I don't think you can 'get' in other parts of the country. It was just so close – measles being transmitted in shopping malls we've actually walked through – it seemed so much more 'real'. That experiential 'realness' of the VPD threat was conformed and strengthened by the legislature and Gov. Brown taking it seriously enough to do something about it. Also, the opponents of SB277 showed their true cranky colors to a public that likely was unfamiliar with how fringey the whole AV stance is in how the 'leaders' express themselves.
If uptake increases, that's not hard-core AV believers being converted. It's the sort of parents who were 'close to the fence' but fell on the non-vaxing side previously now falling on the immunization side. It's a recalibration of, "just to be safe..."
Before Disneyland, fence-sitters most likely were aware of vaccine worries via vague social media posts and real-world conversations, routed through friends who warranted some respect or sympathy, and didn't get into the nitty-gritty details. That is, a lot of this influence came at several degrees of remove from any AV true-believer, just 'worried' folks talking to each othert, spreading a sense of unease that seemed reasonable enough, and wasn't countered much. It was Trump-talk-level vax paranoia: 'I hear all these stories from parents who say the light went out of their kid's eyes after getting the shots. There might to be something to that, right? I think we should err on the side of caution.' The fence folk didn't dig in that far – too busy with other things – and never really considered the VPD angle, just had the general impression that measles was no big deal and a thing of the past. The fact that getting a PBE required action no doubt led to many of the 'worried' going through with getting the shots. But the fact PBEs were so easy to get, compared with the action of taking the kid into the clinic to get immunized, no doubt led to many of the merely worried taking that route.
The whole terrain has changed now, and a lot of parents are simply more worried about disease outbreaks than they would have been before, thus fewer exemptions would probably be sought anyway. But the medical restriction is definitely an added push to the still-wavering: it not only costs some real money, and requires a lot more hassle, but calls for a different level and category of BSing on the application — that is, it's more obviously sketchy.
Non-vaxing is shrinking back to the hardcore AV base and the shift of AV rhetoric to the hard right is hurting the cause outside of OC 'freedom! land', which of course is where Dr. Bob hangs his poopy shingle. Group immunity still could be threatened in some private schools in the OC, I suppose, but in general my guess is that sales of bogus medical exemptions won't be much of a public health threat, and will mainly just put even more money into the bank accounts of Dr. Bob and his ilk, as they continue to exploit the great fear of 'the blight of autism' among the NPD-spectrum set.
These quacks should lose their medical licenses and the parents that try to buy a non-medical exemption should be hauled before a judge by CPS. This is disgusting.
Strange as it may sound, I'm actually glad these rogue docs are being so overt about their profit-driven vaccine exemption services. Silly me, I was worried they'd have enough sense to keep their illicit activities under the table, which would have made it much more difficult to put a stop to them. Keep giving them rope, I say - their own greed and narcissism will do more to convince California lawmakers that they need to tighten up the medical exemption clause than anything we pro-vaxxers could do or say.
Giving them a rope is all well and good, and I'm also glad that they're being so blatant about it, but the fact that kids are potentially going to get hurt by this still sickens me.
The unfortunate thing is they will get away with it. As Orac said the medical boards are entirely spineless. The thing that might drive action would be malpractice suits but they are almost guaranteed not to happen.
Despite the clear deviation from a well established standard of care that they exemptions for sale represent; even if an AVer's kid gets measles or diphtheria or whatever VPD there is almost no chance they will sure. Unless maybe if their child dies, but even then I doubt the pediatrician who provided bogus medical exemptions.
Could immuno-compromised adlults and/or parents of immuno-compromised kids sue Dr. Bob for something-or-other w/o actually being infected (yet)? Could parents of kids who catch measles in an anti-vax cluster sue the Drs. who enable that cluster? Could anyone sue the medical boards for letting this poop pass in failure to meet their mandated obligations?
I wonder if there's going to take another outbreak like the one at Disney to get medical boards to crack down on this.
IANAL, but the answer is almost certainly no. You have to be able to prove an actual injury in order to have standing. The actual injury in this case would most likely be the actual infection. Even then, it would be hard to prove that Dr. Bob (or any other specific doctor) issued the specific exemption that led to this person being infected. I assume that HIPAA applies, because the exemption would have to be presumed valid unless proven otherwise, and medical exemptions are obviously supposed to be issued for specific medical conditions, so publicly identifying a specific student with a medical exemption is likely to run afoul of that law. This is even if you can prove that it was Alice who infected Bill, which is not always the case.
Technically, Dr. Bob et al. are issuing exemptions for specific medical conditions, the problem being that most of the conditions for which they are issuing exemptions are not in fact legitimate medical contraindications.
IIRC, Dr Bob had CA measles patient zero in his care. Maybe I am just dreaming this, but if true, even that was not enough to blunt his shenanigans or get him even a finger wag from the medical board.
@MikeMa, the patient was Dr. Bob's but ended up in a San Diego clinic where he spread measles to infants too young to be vaccinated and other unvaccinated children in the waiting room. Absolutely nothing happened to Dr. Bob; the AAP won't even say anything about this because they are a collective of spineless fops.
Thanks Science Mom. Nice to know my aging brain still functions at some reasonable level.
As to the spineless fops, this seems to be true of more than just CA's medical board. TX let Dr. B continue his crap for decades.
Haven't been back out to California since this law was passed, but I'm expecting to see billboards from quacks touting "get your vaccine exemptions here" just like you see billboards from personal injury lawyers and headhunters looking for jquery programmers.
One very obvious question here
Could this whole problem have been prevented when SB277 was being drafted,by including a list of medical conditions that would be legitimate exemptions to vaccination?Or was such a list included in the bill?I have not read the law itself.
Roger Kulp: remember that one of the drafters of the bill was a pediatrician/state senator. He felt strongly (IIRC) that the decision to write a ME should be left up to the physicians, rather than dictated by law.
There was a bill proposed by Assm. Gatto AB2638: This bill would specify that a licensed physician is not subject to discipline or liability for writing a medical exemption statement.
On April 25, Robert J. Rowen MD wrote on his Facebook wall the following message:
Rowen is the guy who thinks he can cure Ebola (and a mort of other conditions) by injecting sufferers with hydrogen peroxide. Rowen practices with his wife, who he calls is an "integrative physician" -- that is to say, a homeopath. He's been discussed in the comments of this blog.
His practice is in Santa Rosa, California.
@Liz Ditz He thinks you can cure ebola with hydrogen peroxide? Makes you wonder how easy it is to get a medical license...scary thought.
Yes darwinslapdog #7, really.
It occures to me that it is science based medicine to be wary of vaccines for patients with known autoimmune disorders. It would seem plausible that adjuvants intended to evoke an inflammation and immune response could aggravate such conditions. It's not going to be evidence based because there would just be a litany of 'no studies to show' over those 'contraindications. There are those who develop such maladies after vaccination such as with the 1976 Swine flu shot -- Guillain-Barré Syndrome.
So. It's a homogenizing crapshoot, slowly weeding out those individuals and their genetic lines who don't fit the schedule.
The greater good? pfft. 'Get a shot of protection-- The swine flu shot:
'But Dottie had a heart condition and she died' LoL.
"Then why does this report from your own agency dated July, 1976 list neurological complications as a possibility?"
"what kind of shots will we be told to take?"
#20 IANAL, but California doesn't require that someone live in CA in order to file a complaint--anyone on this board could....
The med board might give the complaint less weight, but if there are multiple complaints, they might make a ruling.
clarification, I meant anyone on this blog could file the complaint.
grammar correction: the med board...it might make a ruling
Technically, eczema is a contraindication for getting a vaccination: the smallpox vaccination.
Which is clearly 100% not relevant to children. (A very few adults get it as part of research.)
I know folks who were concerned about vaccinating their kids because both parents had really bad, scary reactions to specific vaccines as kids. But it was a case of "talk to the doctor, and for the first round wait in the office a while in case there is a reaction".
Regarding legal liability of practitioners* who sell medical exemptions that are not justified by the child's condition, I wonder if the child can sue for damages on attaining majority, if the child was injured by a vaccine-preventable disease. That is, if the child is deafened, blinded, or rendered sterile, suffered amputation of limbs, or suffered brain damage, due to a disease for which they could have been vaccinated, wouldn't that indicate malpractice by the practitioner?
Yes, if the practitioner had refused, the parents might well have stormed out of the office and found somebody else to falsify the medical exemption, but that doesn't change the fact that the practitioner was complicit in denying the child the standard vaccines for no good reason and the child suffered easily foreseeable harm as a result.
Oh, and my understanding is that the parents cannot waive the child's claim.
* I am reluctant to call such people doctors or physicians.
It might seem plausible if you didn't know anything about the multiple redundant and tightly regulated mechanisms by which the immune system prevents self-reactivity and promotes self-tolerance. And no, "one vaccine was associated with such a slight increase in a single rare autoimmune disease that 40 years later we still don't know whether it was causality or coincidence" is not a legitimate reason to give rubber-stamp vaccine exemptions to everyone who can dig up a distant relation with psoriasis.
Is it too early to go off topic? Too bad because everybody needs to drop whatever they're doing and watch this week's Last Week with John Oliver right now.
The AIDS Denialists have a similar scam going. For $1,200 they will look at your blood under an Electron Microscope and tell you that you do not have HIV or HepC. And HPV is coming!
23andme . . . ugh. Those people again.
They were given a C&D letter from the FDA regarding their DNA testing for "predispositions" or "risks" for all kinds of genetic diseases because they've never proven their test does anything of the kind. They are not allowed to market themselves for this until they obtain FDA approval for their test as a medical device.
That whole kerfuffle happened a year or two ago IIRC. Ars Technica covered it fairly extensively.
They can and do still market their test as a genealogical resource.
They have, and they do.
Well, they include your carrier status on 36 genetic variations linked to disorders. The list is here -
They do not claim they can identify genetic predispositions to adverse vaccine reactions.
This is the reason their testing cost double what, say, Ancestory, charges.
Agreed. It sets the tone and gives the rational parents the high ground they should have had all along. It sends a powerful message that immunisation is a societal obligation.
Panacea @35: Ugh is right. I know people who did 23andme for the genealogy, but then thought that they had also been tested for the BRCA1 gene (and come out clear) and were super upset to learn that they had not actually been tested for BRCA1/2. (Which is a separate kerfuffle.)
Cartoon on (confirmation) bias.
"It's hard to argue against the power of science. From studies that evaluate the latest dietary trend to experiments that illuminate predictors of happiness, people have come to increasingly look at scientific results as concrete, reliable facts that can govern how we think and act.
But over the past several years, a growing contingent of scientists has begun to question the accepted veracity of published research—even after it's cleared the hurdles of peer review and appears in widely respected journals. The problem is a pervasive inability to replicate a large proportion of the results across numerous disciplines."
It would be nice if people could grasp that science is not black and white. Add in all the other confounding factors and I think a more open mind towards those who question the universal safety of vaccines is warranted. Holding up as standard bearers the quacks and frauds that usually populate both sides of an issue hinders real progress. It also, sadly in this case, has led to a precedent of forced medical intervention. I know this attitude will be ridiculed because you are all so certain about your 'scientific knowledge'. Maybe try reading a bit more broadly about the difficulty especially in biomedical sciences in satisfying one of the most basic tenets of scientific research: reproducibility.
The above article is just one of many in respected science publications that addresses this problem. A bit more humility all around would be refreshing.
@No one important, to a degree I agree with you with, however, the problem highlighted there was an almost complete failure by the original researchers of outlining accurately the research protocols and methods used and the lack of open availability of data. Both valid points well worth addressing and something that definitely needs fixing and I doubt any of the regulars would argue with you. Unfortunately, as John Oliver pointed out in his program on Sunday and linked above at #33, there are no grants awarded to duplicate research by others.
However, when it comes to vaccines and our understanding of its potential risks versus its benefits, it does not rest on the results of one or even just a few pieces of research, but a multitude of such results. As to the frauds, some of them, e.g. Wakefield, deserve all the opprobrium they deserve for the effect they have had on vaccine take up and the damage, and even deaths, they have been responsible for. So if those who claim to be only for vaccine safety actually hang around and even laud and hero worship those already proved to be charlatans and frauds, e.g. Wakefield, then what do they expect.
Who are they and who ever said vaccine safety was universal?
To say nothing of the rather obvious difference between "questioning the universal safety of vaccines" and, bluntly, making shit up or perpetuating blatantly fraudulent claims.
Perhaps I'm misunderstanding you, but your last post confuses me.
You know people who were tested by 23andme for genealogy, they also were given information related to several inherited health conditions that didn't include BRCA, something that 23andme doesn't claim to test for, and those people assumed that test was included, and assumed that the results were negative because nowhere in the info that they received did it say the BRCA test was positive or negative or even mentioned, and now you and those people are upset with 23andme?
And it's completely inapplicable for the use you're trying to put it to. The reference to Ioannidis has to do with positive predictive value. Failure to find an association between vaccines and the endless litany of maladies that they're supposed to cause is a negative result. And, as John Phillips pointed out, the "replication crisis" is not in play, either.
@Narad #45, actually Ioannidis *is* relevant, but not the way it was used. Ioannidis helps explain why Wakefield was wrong. To use Ioannidis as a justification for believing a single tiny study while rejecting hundreds of much larger ones showing it to be wrong is a beautiful demonstration of antivax "logic".
"It would be nice if people could grasp that science is not black and white."
Translation: "It would be nice if people let me ignore all the valid research that refutes my position, while allowing me to tout bad research that independent scientists have not been able to replicate."
Johnny @44: Not quite it: The people were upset because 23anme does test for *some* breast cancer genes. And those tests said "variant not found" or whatever. So they (not totally unreasonably) thought that they had been tested for "breast cancer genes", not understanding that the BRAC1 and 2 genes are patented, and 23andme can't run them.
So it was definitely a case of not reading closely enough (some breast cancer genes != all breast cancer genes). But it was also not super clearly explained, in a way that lay people would understand, that this was only a partial screen of known breast cancer genes.
(I realize I was ambiguous in my first post, is this clearer?)
AP released a story today (when I saw it) stating that a study shows high Folic Acid levels cause ASD. Where the study was published or title of the study wasn't listed.
From 98 to 2013 1391 children were followed from birth and 100 were diagnosed with ASD. Way the story is written it is assumed that 16 of the mothers had high Folate levels and 15 had high B12 levels. It doesn't state whether the high folate levels and high B12 levels are in the same mothers. The article goes on to say that high folate levels means a 17 fold increase in the chance of a child having ASD.
I don't know what the actual study shows but this very bad science reporting by the AP.
For a person that only follows science through press articles like this, I can see them going into a panic. All the woo channels will probably slinging this article around as the TRUTH. More crap to fight.
I don’t know what the actual study shows but this very bad science reporting by the AP.
They're just churnalising the press release:
There is no study yet, only a conference presentation that hasn't even happened yet, and a press department to pimp it.
There is no study yet, only a conference presentation that hasn’t even happened yet, and a press department to pimp it.
Try telling that to the seventeen billion hundred Moms posting about it like it's tru fax on Facebook.
@Delphine: should we run a sweepstake on who they will blame for the neural tube defects that result from folate deficiency in pregnancy? If so, I want the "vaccines" card.
John Philips and Narad, I appreciate the thoughtful responses. I don't agree that various problems with the scientific process don't apply to vaccination research, but I admit, I don't have the time or energy to engage further.
Science Mom, you're right, no one claims vaccines are universally safe. I regrettably used the same sort of facetious statement that is completely counterproductive to an actual respectful conversation.
Dangerous Bacon, I hope in retrospect you would consider your own statement counterproductive. You know very little about me at this point, certainly not enough to condemn me in that way.
Dr. Wakefield and Dr. Sears are not my heroes. I know very little about either of them and am certainly not a supporter of either. I usually do not attempt to discuss these issues online, but since I am in California and have three children who will be affected by SB277, I was discouraged by what I thought was a very condescending attitude toward anyone who has chosen not to vaccinate their children. And on a science blog, at that.
I debated with myself about posting anything further here because I just don't have the time to invest in a meaningful conversation, and for that I apologize for having posted in the first place. I know some will think this means I have no defendable, valid, rational or philosophical position for not vaccinating my children and for being against SB277.
I am very pro-science, trained in science (started out in music actually, but switched to biology and then optics before getting a Ph.D. in nuclear physics) but could not afford to spend years in low-paying postdoc positions (I was an average scientist, not a superstar) so switched to a career with a better financial outlook.
I had an severe reaction to the smallpox vaccination back in 1966. I know that vaccination is very different than current ones my children would have, but still, my starting point in life was that I nearly died from a vaccine. (I'm not exaggerating, I hope that can be taken on good faith.)
I, my immediate family, my husband, and my husband's immediate family (parents, siblings, uncles, aunts) have a history of autoimmune disorders: ankylosing spondylitis (fused spine, no treatment in that case), thrombocytopenia (splenectomy), crohns disease (ileostomy) , peripheral neuropathy (two years IVIG), etc.
There is no good science at this point on who will have one of the rare adverse reactions. Thankfully, my children are all in excellent health. I think most doctors would say I have no valid reason not to have them vaccinated. I would guess many commenters on this blog would agree. I'm fine with that. I think I have a valid difference of opinion of the science and ethics of the matter but I guess I'm not willing to invest the time to try to convince anyone. Sorry, I should not have commented in the first place.
@No One Important, thank you for clarifying your first comment, particularly about you nearly dying after an adverse reaction to the smallpox vaccine. However, as far as I know there is no good evidence to suggest that vaccines can induce or worsen autoimmune disorders. Why you think they might is beyond me.
You also complain about the aggressive response to your first comment. I'm afraid you used antivaccine talking points that we've seen here before numerous times. That was why the other commentators pounced on you. Somebody comes in, makes a few seemingly reasonable comments which are answered, then goes full on antivaxx. We've learnt to spot the signs, and you looked like you were following this route..
@Julian, not completely accurate in triggering bad things with autoimmune, there are exceptions that are very well documented.
Eczema is a contraindication for the smallpox vaccine, lest eczema vaccinatum occur, which is kind of a big deal.
Those contraindications are, as I mentioned, extremely well documented.
Of course, the smallpox vaccine is no longer in common usage now, as the disease is extinct in the wild and typically only used by military and certain public health responders.
Since the removal of mandatory smallpox vaccines, we've had only extremely rare untoward events, as we accepted the slightly higher risk of the smallpox vaccine, due to the 1/3 or so fatality rate of smallpox itself.
Frankly, given today's safety culture in medications and vaccines, I doubt the smallpox vaccine would pass our current regulatory hurdles for safety!
We have all heard the "you can't trust science!" meme from antivaxers and various other woo-shouters who inevitably cite bad and misrepresented science in support of their views. It's an old, moldy chestnut. If there are actually reasons to discard a body of research, they should be presented, rather than attempts to paint all science as defective (which comes off as a major exercise in irony, given that such attempts come from posters using computers and the Internet).
"I know some will think this means I have no defendable, valid, rational or philosophical position for not vaccinating my children and for being against SB277."
"I am very pro-science"
The first statement does not fit with the second.
" I just don’t have the time to invest in a meaningful conversation"
The "I-have-better-things-to-do-gotta-run-bye!" tactic is even older and moldier than "you can't trust science!".
Sorry you had a bad childhood reaction to smallpox vaccine. Fortunately, with the disease eradicated by vaccination, it is no longer necessary, and no other vaccine on the current schedule comes remotely close to presenting the antigenic challenge that smallpox vaccine used to (which itself was nowhere near what the disease itself inflicted on patients).
Food for thought.
Rich Bly @ 47
herr doktor bimler @ 50
This must be the study the AP is talking about.The study has been done,it just has not been published yet.
This should not be confused with the cerebral folate deficiency cause of autism,that I have,and that Belgian researcher Vincent Ramaekers,and others,discovered in the early to mid 2000s.That is also passed from mother to baby in the womb.
HTML screwup.Here's the second link. http://www.medscape.com/viewarticle/863216
@No One Important, I don't think you'll get much sympathy for a philosophical objection here. However, we understand only too well that some vaccines are contra-indicated for some people, which is fine and the reason California included a medical exemption for such cases. However, most immune related conditions aren't contra-indicated conditions with regards to vaccines.
BTW, if we're swapping anecdata, my daughter nearly died from pertussis when an unjustified pertussis vaccine scare was doing the round of the national press in my country in the 70s. Another one of those examples were the press don't understand relative risk or don't care if it makes a good story..
Unfortunately, I was working away from home for long periods so, regrettably, left that side of things to my then wife who, partly through peer pressure of other mothers in her group and partly through the direct result of the vaccine 'scare press itself', decided not to vaccinate our daughter. Unfortunately, with that pocket of unimmunised children in the area, a few years later there was a large pertussis outbreak in my daughters school and round about and my daughter spent three months in hospital and spent another nine "recovering". I put recovery in quotes because later in life she started having health issues that her doctors attribute to the severe attack she had as a child.
Though she was one of the relatively lucky ones of the dozens affected, as a few died and a few were permanently severely damaged and a few relatively mildly but still permanently damaged. All the ones who ended up in hospital and ended up severely and permanently damaged hadn't been vaccinated. Of the few who had been vaccinated and who still got pertussis, none suffered any long term damage and even the worst affected were fully recovered in a few months. I think watching my daughter and her friends coughing their lungs out until the doctors knocked them out, is one of scariest and most horrible experiences of my life, and I say that as someone who has spent time in active war zones. Hence the reason I am extremely ant-anti-vaxxers.
Julian, Wzrd, and John, thanks again for thoughtful responses. I regret dropping out of the conversation, but I appreciate at least having some thoughtful feedback and discussion while I was here. So thank you for the time you invested and giving me the benefit of the doubt in your responses.
So you’re just going to pile on more characterizations that don’t apply to me or what I said? How is that in any way interesting or rewarding to you?
I am a slow writer. My previous response probably took over an hour to compose. I rarely post on the internet on anything and especially anything complex (to me, I know for many this is a cut and dried issue) for that reason.
I'm not anti-vax. I am pro-science. I haven't had my children vaccinated and I believe my concerns are valid. I’m also against SB277 and think it is the wrong approach for both practical and philosophical reasons. However, I don’t have a concise statement about it that won't be open to all sorts of misinterpretation and will take many follow up posts to clarify.
My son, whose in fourth grade, will be switching schools for fifth, and therefore I need to decide what to do regarding vaccination for him this summer. My daughters will be switching districts for high school next summer, so I over the next year I will have to decide what to do for them. I did a quick google search to see if there was anything new on SB277 and landed on this article. And was frustrated as I often am about the tone of most of the online conversation about anything controversial. I've never posted to this blog before, and I think the last time I posted anything about vaccination was almost a decade ago on a writers' forum.
I in no way support 'buying' an exemption and will not do that myself. I don't live in a pocket of non-vaccinated children. I live in a low income. largely immigrant neighborhood that has very high vaccination rates.
Dangerous Bacon, I hope I don’t warrant any additional criticism but I understand I had no good reason to post here in the first place so if my comments are still perceived as some effort to troll or stir up anti-vax sentiment (?) I’m fine if they are removed.
This post has taken me an hour to compose and I am still not satisfied that I’ve addressed the important points in an adequate manner. My apologies.
"I’m not anti-vax. I am pro-science. I haven’t had my children vaccinated and I believe my concerns are valid. I’m also against SB277 and think it is the wrong approach for both practical and philosophical reasons."
If you were sincerely pro-science you would have given some actual scientific reasoning for the next two sentences.
I'm calling some questions here, No One Important. You state that you reacted to a smallpox vaccine in 1966. Well, first, they weren't given until at least a year (if not 4 years) of age. So you were born in 1965 or earlier. And now you are saying you have a 4th grade (i.e. 10-11) year old son. While it's not impossible, it's rare we have a true antivaxxer who had children in their mid 40's.
And it's so nice you live in an immigrant, highly vaccinated neighborhood. Nothing like hiding in the herd, is there. Did it ever occur to you to wonder WHY those immigrants feel vaccines are so important?
You don't have to reply since it takes you so long. You can just accept my anger and scorn for a freeloader.
MI Dawn: "Well, first, they weren’t given until at least a year (if not 4 years) of age."
I was born in the fall of 1957, this is the transcription from my "Dept. of Defense" shot record (I was a military dependent who was born and lived overseas for about a third of my youth, which is why my last smallpox was after it was dropped in the USA):
23 Jan 58 (no take)
20 Mar 58
13 Aug 59
30 Mar 68
6 Apr 68
7 Sep 71
20 Jun 74
"Did it ever occur to you to wonder WHY those immigrants feel vaccines are so important? "
I know why! These are also on my old battered DoD shot record:
26 Aug 59
3 May 68
18 Jul 59
26 Aug 59
31 Aug 59
6 Apr 68
14 Jun 74
13 Apr 68
18 May 68
For some reason, this spring our hospital campus has been very attractive to the local duck population, which waddles about pursuing mates, nesting in less than suitable locations and quacking loudly.
At least, because they look like ducks, waddle like ducks and quack just like ducks, I've been assuming they are ducks.
But perhaps I am piling on characterizations, and they're actually black swans.
@Chris: as a civilian, I never heard of smallpox being given earlier than a year, and most of my friends and I got it between 3 and 5. The military, as you know, goes by its own rules and needs. :)
I was just pointing out that a lot of No One Important's story doesn't hold a lot of water without some additional explanations, and the fact that she/he and their family are hiding in a very protective herd is disgusting.
Very briefly, I am sincerely pro-science. This article gives some of the reasoning about science that can cause pro-science people to question getting vaccinations:
I have no idea what the broader political stance of this website is, nor am I familiar with the author or her main subject. I just ran across it and think this article does a fairly good job of discussing some of the issues, in particular my frustration with how 'moderate' ideas are reacted to.
I am becoming aware that I inadvertently posted on a site where there really was nothing I could add to the conversation. If I had even taken note of the blog title, "Respectful Insolence," I could have saved us all a lot of time. So, again, my apologies. If I hadn't momentarily given into a deeper frustration I have with the tenor of the public debate on this issue, I wouldn't have posted here at all. Let me repeat, this clearly is not the right forum for me to have posted in. I see the article I posted a link to is over a year old. I'm guessing it has been thoroughly 'debunked' a year ago on this site, but on the off-hand that you are serious about trying to understand how a pro-science, and even scientifically trained, individual could not vaccinate their children, here is part of the picture.
If you would all be willing to let me gracefully bow out of the conversation now, I would appreciate it. I'm sorry for any 'anti-vax', 'science-denying' rhetoric I am somehow inadvertently spewing despite my beliefs. Rest assured, my children will likely be fully vaxxed in the next few years. The good work of the state is being done, irrational idiots like me should of course not have a say in the matter. I concede defeat, I am wrong, you all are 100% in the scientifically proven right.
"...on the off-hand that you are serious about trying to understand how a pro-science, and even scientifically trained, individual could not vaccinate their children"
Attempts to "understand" why a "pro-science" and "scientifically trained" individual could embrace antivax pseudoscience would be aided immeasurably if you'd deign to respond to specific questions and comments about your statements.
Instead you seem to be playing the "you're all meanies" and "I'm wasting my time" cards in preparation for the dramatic flounce out the exit.
I would like to think you're a truly thoughtful person who inadvertently stumbled into an indefensible position, but sounding these classic woo/antivax memes that we've heard over and over convinces me otherwise.
Well, No One Important, provided you're serious and not a troll I have some advice for you: get in your car, drive down to your local police precinct, and tell them that you are guilty of gross negligence. Throw in a call to CPS as well since they're probably going to want to know. Think of your children. They deserve better than this.
MI Dawn, I was born in 1965 in NY, was vaccinated shortly before my first birthday in NY, became ill on a trip my family was taking immediately after to Indiana, spent my first birthday in the hospital in Indiana. Eventually I was given gamma globulin special ordered from Germany (I have no idea why it would have had to been ordered from Germany) and it sounds like that's what helped me finally recover. I don't really have many more details. My mother could tell me where I was hospitalized if you really want to try to track down records. I had my daughters at 38 years old, my son at 41. It's not that unusual where I live, certainly not to the point where it would call someone's narrative into question. And just to pre-empt your next point of misguided outrage, I did not use medical technology to become pregnant, but would have been grateful for it's existence if I had needed to. As for your anger and scorn, I would have had it regardless of where I lived.
1. I had a severe reaction to a vaccine and have heard about it my whole life. That's an emotional reason that would compel me to question the science behind vaccines and the risks more strongly than another. If I hadn't had that experience, it's quite likely I would have never given vaccines a second thought.
2. History of autoimmune disease in family, leading to similar effects at #1.
3. Training as scientist with experiences that lead me to have a longer view approach to what I take as scientific fact
4. Some of the things touched on in article I linked to as to how science is used in public policy decisions
I'm not interested in flouncing out, I'm getting frustrated with the pointlessness of you and I having a conversation. Can you not agree that this discussion is not going to go anywhere? I'm sorry I don't have the next six months of my life to do a thorough review of all the scientific literature and the way policy decisions are being made to convince you I might have a leg to stand on. I've made a good faith effort to be honest with where I'm coming from. It's obviously not enough for you. Instead, it seems like you have to characterize me as 'flouncing' or 'post-and-run' or whatever to feel comfortable with me leaving this discussion. Not to mention other pointless jabs such as the duck-swan post. I sincerely hope this is somehow adding to your day, because it sure isn't adding to mine.
Roger Kulp @57:
This must be the study the AP is talking about.The study has been done,it just has not been published yet.
That is a better way of putting it. If I understand correctly, the conference presentation should have happened now, and other researchers will have had their first look at the data and the statistics and the conclusions.
I remain gobsmacked that the press department blasted out a press release before that point, based on nothing but claims from the John Hopkins Bloomberg team (unencumbered by everyone else's feedback), and that the AP and other media regurgitated it, blithely unconcerned about the potential for panic. It is as if they were primarily concerned with headlines.
It is as if they were primarily concerned with headlines.
In other news, yay. http://www.cbc.ca/news/canada/toronto/vaccination-legislation-1.3580593
Especially this part The legislation would also require health-care providers to report to the public health unit what vaccines are given to children, in an attempt to reduce school suspensions over out-of-date immunization records.
It currently falls on parents or guardians to ensure children's vaccination records are up to date, so the change would reduce that burden while strengthening the reporting system.
Well, No One Important, your story is still curious - I, too, wonder why they had to get gamma globulin from Germany. I am NOT a doctor, especially not immunology-specialty trained, but the story just doesn't medically make sense to me. I am not doubting the story you have heard, mind. But I well know, from my own experience, that stories get changed over the years when they are told. (My mother insisted for years that she'd had chicken pox and measles in the same year; it turns out from family letters of the time, it was mumps and measles).
I have nothing against ART. I think they are wonderful and have worked to broaden policies to allow coverage of them. It's wonderful that you didn't need them.
You keep stating you are a scientist. That's good. But not all sciences are the same, and training in one does not equal ability to understand others. I honestly think you believe you have researched vaccines. But if you had, you would realize that your family history is NOT a reason to not vaccinate.
My kingdom for an edit function....I am not a doctor, though I am medically trained, especially not immunology-trained...
MI Dawn: "@Chris: as a civilian, I never heard of smallpox being given earlier than a year, and most of my friends and I got it between 3 and 5. The military, as you know, goes by its own rules and needs. :)"
Thanks, that is good to know. I seriously had no idea.
Though not long after we met, hubby (then boyfriend, it was not an arranged marriage) and I compared smallpox scars. Something our kids can never do. Yippee!
"Well, No One Important, your story is still curious – I, too, wonder why they had to get gamma globulin from Germany."
I did a quick Google on "gamma globulin history" and found some scattered stuff. It has been around for over a century, and getting enough was a problem, plus there was danger of contamination. It also seems to be the reason for some HepC infections.
Okay, freak out time ---- my hubby ate at a sandwich shop that had an HepA infected employee in the 1990s. He had to go in for a shot of gamma globulin. Hopefully his was without the extra HepC.
But, I agree, the stories No One Important was told could have changed over the years. While searching around for my family's history I have found several things that my dad mucked up in the telling. He was twenty years off on my maternal grandparents' wedding date (they were married for over twenty years before my mother, their only child, was born --- he was probably given a story to excuse the years and years of trying, so either several dead babies or adopting a relative's child, the former is most likely). My dad also has no idea that his mother was adopted (though I never got complete verification from the source of that information).
Also, a reaction to the smallpox vaccine is not a valid reason to not vaccinate her family. Why would you compare a 200+ year old vaccine to more modern vaccines? They are not even the same, and many use completely different technology.
Paul Offit was someone who opposed getting anyone who did not need it vaccinated for smallpox. The danger from the vaccine is much much more than the risk of getting the now extinct disease. There is a real reason why we use the IPV for polio and not the OPV. And on and on.. the vaccines of the 1960s are not the same as they are for the 2010s.
By the way, two good books about vaccines and vaccine safety are:
Pox: An American History by Michael Willrich
The Cutter Incident: How America’s First Polio Vaccine Led to the Growing Vaccine Crisis Paperback by Paul A. Offit
Yes, vaccines are not perfect. Scientists and others strive to make them better. They are still much much safer than the actual diseases.
Just saw a comment from someone new: Ryan A Rognas
Really not helping. No One Important has a fear based on a fractured family story. Though if you want to have real entertainment, please deal with someone who is from Woo Zealand here:
NOI: "I had a severe reaction to a vaccine and have heard about it my whole life. That’s an emotional reason that would compel me to question the science behind vaccines and the risks more strongly than another."
Someone who claims to be "pro-science" and having "training as scientist" should know better than to base their beliefs on an "emotional reason", stemming from a reported reaction to a vaccine 50 years ago, when the vaccine in question (for smallpox) was long ago dropped from the pediatric schedule because it eradicated the life-threatening disease it was created to address. Further (as I noted earlier), smallpox vaccine was much different from the ones on the current schedule, in part because it provided much greater antigenic stimulus than current vaccines.
Of course, that's one of the numerous points you've failed to address in favor of griping about not being taken seriously and exclaiming about how science could be wrong (without bringing up a single example from the large body of existing vaccine research to demonstrate why you think it is (or could be) flawed).
In my experience, that's how scientists approach an issue.
@No One Important, I'm a bit puzzled by your comment in #66 where you say:
What's stopping you from bowing out of the conversation now? You are under no obligation to respond to us. Or are you one of those people who wants to have the last word in every conversation?
I've got less than zero tolerance for anti-vaxxers since I've got ASD and the way they treat autistic kids sends me through the roof, and at this point I'm beginning to think NOI is a troll.
If I thought he was genuinely on the fence I'd be the first to try the reasonable approach but the more I read the more I'm seeing the typical anti-vax resistance to reality covered with a veneer of civility.
Chris and MI Dawn, I don't understand what part of my medical history either of you find so remarkable. That I was vaccinated shortly before my first birthday? That I had a severe reaction? That gamma globulin was used to treat it? The only part which I find puzzling in what my mother has told me, and clearly drew attention to myself as something that seemed odd, was the part about having to get the gamma globulin from Germany.
I'm not going to do a thorough web search to convince you, but maybe this is of sufficient quality?
"Studies from the 1960s indicate an overall rate of complications of 1254 per million primary immunized individuals.6,10–12 In the past, vaccinia immune globulin (VIG) was used to treat and decrease the severity of many of these complications, but only about 600 doses of VIG currently are available. Using 1968 US data, at least 40 individuals per million immunized developed significant and potentially life-threatening complications for which VIG would be used."
"Before its discontinuation, universal smallpox immunization was recommended in the United States for children 1 to 2 years of age. "
You're both in medical fields and I'm sure have much easier access to this information than I do.
There's no reason to doubt what my mother told me about this. In fact, she probably could dig up some ancient documents as 'evidence'. She at any rate has my vaccination 'card' that indicates I was vaccinated when she said.
With respect to all, NOI is correct that gamma glob was used as a relatively common treatment for various viral infections.
In the case of progressive vaccinia or eczema vaccinatum, it was specific. I recall seeing those in some ancient medical books when I was young and reading doctor's library in his office while awaiting appointments. While the words were odd, doctor was good enough to explain them to his insatiably curious patient.
I had a reaction, which my parents described as ascending and descending my arm and spreading to my chest, although I never found a sign of a pustule scar anywhere but the vaccination site and doctor "gave me a shot" that he had ordered, my parents being lay and clueless, only knew that it was "really, really bad", which cleared the issue up.
The military was disinterested in that information on my initial vaccine series as too vague and proceeded with the full series.
For the record, having received the yellow fever vaccine, it sucks - but nowhere as bad as yellow fever infection would suck. Just felt like crap within a few hours, sore as anything for a few days. I was one of the ones who would run a low grade fever a few hours after a full battery of immunizations in the military, to be recovered enough to help the handful of others feeling similarly the next day. I'm also the odd one that is immune to poison ivy and only mildly reacts to poison oak or poison sumac.
Things immune can be a bit tricky, in odd ways, some reacting early, some not reacting at all and with the smallpox vaccine, some would never have an immunization that would "take", leaving them unprotected.
That specific vaccine was and remains the most highest risk vaccine of our arsenal of vaccines against communicable disease, with up to a 1% adverse reaction rate, with severe life threatening reactions still witnessed today in military and specialist public health care recruits. Fortunately, with antiviral drugs and specialized protocols, we've finally arrived at a 100% successful treatment rate that results in no mortality or morbidity from an unchecked or defective reaction to vaccinia infection.
That said, I was only a Special Forces medic, while I received a lot of highly specialized and broad training, a doctor, I'm not. But, I can talk shop with a specialist, understand and even learn a few new models that I was unaware of previously. :)
The problem is, comparing the smallpox vaccine to any vaccine in today's common usage is like comparing apples and a hand grenade, not only wrong species, one's technology, rather than fruit. Totally different beasts, risk factors for disease vs adverse reaction and human cost of unchecked infection, technological level and I was quite serious that I doubt that the smallpox vaccine would pass all of our current regulatory hurdles in place for safety, were it submitted as a new vaccine today. I'd still accept the risk and vaccinate my grandkids and kids with it if smallpox were to become pandemic, but I'd be the first one raising merry hell demanding a superior, modern vaccine.
You know, extremely low risk vaccine.
Can things go sideways with a vaccine? Things can go sideways with a sterile water injection, I've witnessed frank anaphylaxis with a sterile water injection performed in a training environment.
The immune system might be "blind" to a live attenuated virus injection, a live attenuated virus may reactivate (witnessed in OPV administration areas, which is why areas where wild polio is absent don't receive OPV vaccines at all).
Life is complicated, antivaxers, seeking life to be simple.
Dead is simple, you're dead, you don't get simpler than that, life is complex and in any medical procedure, there is a risk - even taking a patient's blood pressure or pulse.
The idea is, don't expose a patient to a higher risk than the risk of morbidity or mortality of the disease.
We've gotten really good at that.
Even in cancer treatment.
Said by one exposed to many, many known carcinogens over his life and military career, as well as one uncontrolled ionizing radiation exposure that I cannot discuss.
I'll only say, I began my military career working with Pershing Missiles.
I stayed to try to clarify the basic stuff that does not take a lot of time. So, if someone is doubting me because in their experience no one got the smallpox vaccine until age 3-5, it seems reasonable to provide support showing that it was indeed given at younger ages. I'm not here to troll and I am trying to exit the conversation gracefully, but I would prefer to do it without being accused of flouncing or insisting on the last word.
Sonnie, I got to witness and actually remember, while still in diapers, JFK's assassination.
I strongly suggest you re-review my comment, as I'm older than you are and the texts are of the date you are speaking of.
NOI: "So, if someone is doubting me because in their experience no one got the smallpox vaccine until age 3-5, it seems reasonable to provide support showing that it was indeed given at younger ages. "
You must have missed that I got my first smallpox vaccine when I was three months old, and another three months later because it did not take. So, yeah, some of us got it very young.
Still, there is a reason that smallpox vaccine has not been on the American pediatric schedule for over forty years.
If you actually look at the evidence, the overwhelming majority of the people who caught the measles in the Disneyland outbreak were 100% up to date on their immunizations. It seems if vaccines are so safe and effective they should not have contracted the illness.
Apparently, CDC doctors that have come forward to say that fraud was committed and documents destroyed (he saved some of the documents as proof) showing a lack of efficacy and numerous adverse side effects mean nothing.
Why is there the "National Childhood Vaccine Injury Act of 1986" which removes liability from manufacturers if they are so safe?
Why have courts in other countries ruled that there MMR does have a correlation to Autism.
Why is does the United States have the most vaccines on the schedule with the highest doses and we also have the highest infant mortality rate of any first world nation?
Doesn't seem strange to you that the third leading cause of death is medical error from medical professionals?
Just food for thought.
The US vaccination compensation programme and attendant legislation exist primarily because vaccine manufacture is not very profitable (in contrast to the anti-vax narrative) and frivolous lawsuits and capricious jury awards threatened to see all vaccine manufacturers pull out of the US. So now claims for vaccine injury are heard by a specialist panel - which gives the benefit of the doubt to plaintiffs. This panel heard the best cases advanced by the vaccine-autism crowd, and found them to be without merit for the same reason that Wakefield's results were also without merit: there was compelling evidence of autism before the vaccines were administered.
1) it was not an "overwhelming majority", more like around half.
2) Given that the vaccination rate is over 90%, that means that the unvaccinated were 5 times as likely as the vaccinated to catch the disease. Learn the concept of relative risk.
Orac has discussed this in various posts on this blog. Suffice to say, it looks like fraud was not committed, and you should comment on those posts.
Wrong. The manufacturers can still be sued for design and manufacturing defects.
Which countries? Only one court in the world, a Lower Court in Rimini Italy, returned such a verdict, and it was overturned by a higher court.
Firstly, the US has a much tighter definition for stillbirth, meaning that children who in other countries would be reported as stillbirths are reported as live in the US but die anyway.
Secondly, citation needed for both "most vaccines" and "highest doses", whatever the latter means.
You probably think you're oh so clever. In reality, you're another tedious antivaxxer spouting P.R.A.T.T.s that everyone here has seen and seen refuted litetrally doznes, if not hundreds, of times.
P.S. Ray, Natural News and "Health Impact News" are not reliable sources.
Recent research indicates that vaccines may induce or worsen autoimmune disorders via chronic stimulation of the immune system:
Shoenfeld, the editor of the Vaccines and Autoimmunity textbook, has developed the concept of Autoimmune (Auto-inflammatory) Syndrome Induced by Adjuvants.
How could adjuvants cross the blood-brain barrier? Either by macrophages, according to Shoenfeld, or via the lymphatic system, given recent findings about lymph vessels in the brain
"In 2011 Shoenfeld and Agmon-Levin proposed a new syndrome as a way of grouping together a range of emerging autoimmune diseases with possible adjuvant-associated causes, Autoimmune/Auto-inflammatory Syndrome Induced by Adjuvants (ASIA). At present, there is no evidence to suggest that ASIA syndrome is a viable explanation for unusual autoimmune diseases. Since the initial paper, over 80 publications have discussed ASIA. This systematic review examines the research that has been done to investigate whether ASIA is a broad umbrella term with little clinical significance, or whether there is some underlying mechanism which could be utilised to reduce the occurrence of adjuvant mediated disease. Twenty-seven animal, epidemiological and case studies were reviewed. Unfortunately, a robust animal model of ASIA using biologically relevant doses of adjuvants has yet to be defined. It is also apparent that the broadness of the current ASIA criteria lack stringency and, as a result, very few cases of autoimmune disease could be excluded from a diagnosis of ASIA. The current studies involving human cases are so diverse, in both external stimuli and in resulting conditions, that there is currently a lack of reproducible evidence for any consistent relationship between adjuvant and autoimmune condition."
"Recent studies implicate a web of mechanisms in the development of vaccine adjuvant-induced autoimmune diseases, in particular, in those associated with aluminium-based compounds."
"Can Vaccines Cause Autoimmune Diseases? The Science Says No."
Hmmm, a corporate website marketing piece with outdated citations, and a blog post by a surgical oncologist about antivaccine cranks.
If you read the Shoenfeld interview cited above you would see this comment "I would like to clarify that I am definitely not against vaccines! Vaccines are the best medical development that humankind has had in the last 300 years, and have helped to bring about almost complete eradication of some viral diseases. However, it should be considered that when you give millions of people an active substance, and vaccines are active substances, then some may suffer from adverse events. After all, vaccines contain viral or synthetic particles emulsified in adjuvant, which is supposed to enhance the immune reaction. So, we have to identify the people who are at risk of suffering from side effects due to the chronic stimulation of their immune system."
I recommend Shoenfeld's textbook. The electronic version on Amazon is much less expensive than the Wiley website.
ASIA = sore arm
Shoenfeld is paid by the Dwoskin Family Foundation. They like funding anti-vax drivel.
Scientific references from 2014 are "outdated"? Who knew?
"a blog post by a surgical oncologist about antivaccine cranks."
Did you happen to notice the blog you are posting comments on? They are one and the same. If the site is so disreputable, what are you doing posting on it?
Shoenfeld: “I would like to clarify that I am definitely not against vaccines!"
Of course not. No antivaxer, nor anyone who gives credence to antivax memes is ever antivaccine (J.F.K. Jr. for example has taken pains to assure us of his pro-vaccine bona fides).
Shoenfeld has long been engaged in FUD-spreading about vaccines despite a singular lack of evidence.
" A heated debate is going on regarding the causality between vaccines, such as measles and anti-hepatits
B virus (HBV), and multiple sclerosis (MS). Brain antibodies as well as clinical symptoms have been found in patients vaccinated against those diseases. Other autoimmune illnesses have been associated with vaccinations. Tetanus toxoid, influenza vaccines, polio vaccine, and others, have been related to phenomena ranging from autoantibodies production to full-blown illness (such as rheumatoid arthritis (RA)). Conflicting data exists regarding also the connection between autism and vaccination with measles
I guess he's just Teaching The Controversy.
Orac noted previously that Shoenfeld has testified in "vaccine injury" litigation (the NVICP has rejected the claim of ASIA-caused illness (as noted in the link below) and ran a journal that published papers by the Geiers, which does not enhance one's reputation for scientific rigor).
Why is does the United States have the most vaccines on the schedule with the highest doses and we also have the highest infant mortality rate of any first world nation?
Differences in reporting (as Julian noted above) and poverty/inequity. Infant mortality rates amongst wealthy American mothers are on par with countries like Finland, Japan, and Portugal. Poor babies lack access to resources, chiefly health care. Poor Moms are more likely to deliver early, and preterm birth is the leading cause of death for children under the age of 5.
Has nothing to do with vaccines.
Following up with Delphine @98: deaths that are reported in the USA as "infant mortality" are reported as "stillbirths" in other countries, because of differences in definitions among countries.
Also, poverty is a huge driver of infant mortality rates.
As a side note: If you define 'infant mortality' as death before 30 days, then how could it be vaccines, as an infant gets, what, one vaccine at birth? (HepB?)
It should be no surprise that the US has a high number of vaccines on the schedule, given that the US is the wealthiest nation on Earth and can actually afford to go after more diseases, and can afford the extra insurance of additional boosters. Different countries have different priorities and different economic capacity.
Okay, so only 50% of the total 4 citations are outdated on your corporate marketing piece.
You say Shoenfeld “ran a journal that published papers by the Geiers”…can you specify which journal? Shoenfeld is or has been an editorial member for 65 journals. Please specify. Your “anti-vax” ad hominem feint is lame.
Disreputable? You proposed that adjective, not me. My motives are much more selfish. I wish Orac would confine his considerable talents and energy to his chosen specialty: breast cancer. I am currently undergoing breast cancer treatment for a rare and aggressive subtype. I believe that Orac could help many more children by saving their mothers from death by breast cancer than by spending so much time and energy on vaccination issues. How many U.S. children die from vaccine-preventable disease? How many U.S. children lose their mothers to breast cancer? Help where the need is greatest. Help the children by focusing on research to save their mothers, instead of obsessing about the low U.S. vaccination exemption rates. Please. There are plenty of U.S. pediatricians to attend to the childrens’ health care needs.
Your backtracking is welcome, but you'd have to specify why articles from 2001 are outdated. Which you haven't done, anymore than you've addressed the failings in Shoenfeld et al's research as detailed in the review to which I linked.
The "don't pay attention to the issue I don't want you to pay attention to" meme is lame in the extreme.
Good luck with your breast cancer treatment. I will refrain from suggesting that you confine your online efforts to urging more research into breast cancer, instead of wasting time with antivax postings.
You have misunderstood, again. I do want both issues to receive maximum attention: the possible link between adjuvants and autoimmune disease, as well as breast cancer.
As for failings in Shoenfeld's research...in the Skeptical Raptor piece you linked to, the Special Master's comments "described the ASIA theory as “like a sapling” and concluded that it was not far along enough in its growth to provide a basis for recovery." So the ASIA theory isn't ready for prime time when it comes to doling out government recovery dollars for vaccine damage. This does not equate to declaring ASIA a non-plausible theory.
Your final comment "I will refrain from suggesting that you confine your online efforts to urging more research into breast cancer, instead of wasting time with antivax postings." is uncannily the message I gave regarding Orac's behavior. As a parent, both vaccination and cancer issues are important to me.
Orac can do both.
You do not realise just how foolish your rhetorical question is. If vaccine rates aren't brought back up, herd immunity will stay eroded and outbreaks will start to increase in both number and size. We've already seen what happens. Thanks to Wakefield's lies vaccine rates for Measles, Mumps and Rubella fell, and there have been outbreaks with fatalities.
Yeah. Antivaxxers frequently deny that they are antivaccine, then resort to FUDding around and JAQing off. It's kinda like "I'm not racist, but..."
"Your final comment “I will refrain from suggesting that you confine your online efforts to urging more research into breast cancer, instead of wasting time with antivax postings.” is uncannily the message I gave regarding Orac’s behavior."
Nope. Try again. I explicitly rejected your brand of attempting to suppress discussions of which you do not approve.
" So the ASIA theory isn’t ready for prime time"
Correct. Which also means that it shouldn't be the focus of endless reruns by antivaxers.
"Antivaxxers frequently deny that they are antivaccine, then resort to FUDding around and JAQing off. It’s kinda like “I’m not racist, but…”
One wonders how Shoenfeld squares his I'm-not-antivaccine statement with his appearances as a speaker at meetings of antivax groups. You'd think that a scientist who wanted to maintain an appearance of objectivity would steer widely clear of such engagements.*
*for instance, his speaking at a "vaccine safety conference" alongside such antivax luminaries as Russell Blaylock, Andy Wakefield, Lucija Tomljenovic and Barbara Loe Fisher.
But Shoenfeld isn't antivax.
December 23, 2008
Wonder how long it’ll be before Dr. Jay gets a book deal (“Stick It To ‘Em – A Maverick Pediatrician Takes On The Big Pharma-Medical Complex”) or starts selling his own line of nutritional supplements.
He doesn’t strike me as the sort of guy who’ll be content with Celebrity Pediatrician status and making the occasional TV appearance.
And when the health of his patients (and the rest of us who are exposed to their preventable infectious diseases) suffer as a consequence of his foolishness and ego, he’ll find someone else to blame.
I still don't have a decent book deal and that line of supplements isn't in the works either. Eight years, Bacon! We've been online buddies for at least eight years. More, actually--right, Orac? Here's to another eighty years of camaraderie, Dangerous Bacon
Still FAAPing after all these years.
Don't worry about the book deal, Jay, you can always self-publish an autobiography detailing the exploits of a maverick M.D. and lactation specialist who defied the establishment.
One-time nephrologist Suzanne Humphries launched her vanity press offering in June ("Rising From The Dead"). The blurb on Amazon describes how she was on the road to suicide like many other docs, but apparently homeopathy and antivax advocacy steered her back from the brink and into a (hopefully more lucrative) career as an author, lecturer and private practitioner of something-or-other.
Actually, Jay is too modest.
In addition to the classic "Good Nights: The Happy Parents Guide To The Family Bed" (which he co-authored in 2002), Jay came out with the seminal work "Preventing Autism" in 2013 (can't think how I could have missed it), which includes "sensible" advice about vaccination. Fellow pediatrician (and FAAP) Chris Hickie has an enthusiastic review:
And for those of you who enjoy antivax rock n' roll in the style of The Refusers, Jay has recorded several albums*, also available on Amazon. For instance:
U rock, Jay!
*it may be this is not the same Jay Gordon, as he reputedly is more into skiffle.
The problem is so much larger than anyone is talking about. Wait until the new research comes out.
Hi Steven, what problem and you know the results before the research is published?
Yes Steven, this is way worse. The Illuminati are putting Autism Factor inside of each new vaccine.
Don't let them lance-rape you with vaccines.
This site has all of the relevant info on vaccines: http://vaccinepapers.org/
Aw, yes... Vaccine Papers where the studies were all hand cherry picked for your endarkenment.
Ah, the Vaccine Papers! Ain't that the site that claimed that I was a space alien?
I fired a doctor for thinking that I was an alien.
Apparently, he never heard of hyperthyroidism. Or, well, PCOS or any other malady.
Or even pediaprofen, back in the years shortly after 1990.
First, I'm not human, but successfully reproduced with another human and then, didn't know an increasingly common drug for children.
Yeah, totally got fired for cause. That lead me to an entire rejection of urgent care centers, due to a lack of due care, due diligence and worse, continuity of care.
Given a choice between an ED that lacks a physician due to a disaster and a fully staffed urgent care, I'll go with the ED.
The nurses learn a lot over time and I'm quite good at emergency treatments anyway.
Wzrd1 said: I’ll go with the ED.
Really? They have pills for that now ya' know.
Indeed, Vaccine Truther #119?
So, if I have a heart attack, there's a magical pill or some other bullshit?
There's a magical pill to repair a previous physician's malpractice that ignored three vertebrae being fractured and two more recently fractured?
As she has her entire cervical vertebral system crushing spinal cord *and* a severe herniation of L5-S1, I honestly wish the worst for you and your entire extended family.
As I'm trying my level best to avoid family unfriendly conversation, that's pale compared to my actual thoughts that involve vivisection of you.
Oh, BTW, she requires injections to treat advanced and previously ignored osteoporosis.
If she's operated on now, it's even money that her vertebra will turn into dust.
So, I have an assignment, think of the most horrific death imaginable to you, add to that and that's my wish for you.
And something about having sexual intercourse with a howitzer cleaning system.
For the record, such thoughts normally horrify me, however, your notion that my wife's dire condition could be cured by some bullshit pill, I honestly want to plant my tomahawk into the cavity that contains your shitty excuse for a brain.
After having you hung, drawn and quartered.
Might I suggest that you go away? Now.
Lest I abuse the public trust?
For the record, for those who aren't conversant with things medical, which antivaxers claim that they are, the ED is the Emergency Department.
It's a department, no longer a fucking room.
So, the slight is rejecting half a century of change and BTW, Viagra works quite well for me, despite my dose of Metoprolol.
My stance remains unchanged, as my wife remains untreated for spinal cord compression while the insurance company argues against osteoporosis injections. Or, whatever they actually argue about. It's only two weeks since we've learned of the significant injuries
The only thing saving our former malpracticing physician's very life is, I retired from the military, quite literally, in the middle of a shooting war.
The notion of causing harm to another person fills me with horror. To the point of nausea.
But, that single physician's disservice does very nearly override that nausea.
Largely due to his attitude of "female hysteria" bullshit.
As for you, you mewling quim, go away, you annoy me and contribute nothing beyond ignorance, which I can get from my cat.
Who actually does have a bit of a mind.
Are you the bloke who cropped up here just over a year ago, claiming to have knowledge of some "research" which would absolutely blow vaccines out of the water, but then disappeared without sharing it with us?
Or are there more than one of you?